Professor Michael Molloy:

Prevention is the most important part of this, preventing the injury from occurring. If there is a situation one can envisage that increases the risk of the injury, then one has to consider that. First, there is the sporting bodies and if they do not take it on, then somebody else needs to, but the sporting bodies have a major role to play. I was involved in the past with the International Rugby Board, IRB, and I was one of the signatories to the concussion statement issued in 2008. The IRB then had a responsibility. It took two years to draw up the documentation and it took ages to get consensus because there were many differing views on it, but eventually the IRB put together a package that all the other countries use and it was translated into seven languages at the time. The biggest users of it were the Chinese and they do not play much rugby.

There is a need for the sporting bodies, for example, in a sport like rugby where there is a good deal of head contact, to give this issue serious consideration. Perhaps we should add to that the question on the bulking. That is the problem. The bigger the players are, the bigger the collision, and the wearing of helmets comes into that. Helmets do not protect players from concussion, that is for sure. Even in American football where they have specially adapted helmets, it does not work, but it does prevent, as Professor John Ryan said, injury to the face and fractures. I think equipment in the helmet is now used to measure the contact force. Dr. Éanna Falvey will mention this when he speaks shortly but the contact force on the head can be measured by using equipment in the helmet. It does not protect one but gives a false sense of security and for children in particular, it should be outlawed. In rugby it does protect the player's ears. I know from my experience that if one did not wear it in the forward position one's ears would look like those of Dr. Spock.

The other question raised was on who decides in this regard. The medical person on the day has to make the decision. I would go further, and my colleagues would agree with me, by saying that it has to be a decision that is made instantly, without dependence on the sports concussion assessment tool, SCAT. We have copies of the SCAT if members want it.